The GOP’s emergency-room argument never dies

CBS’s “60 Minutes” ran fairly long interviews last night with both President Obama and Mitt Romney, and the latter made some news with answers on tax policy. While they’re likely to have a political impact, substantively, the Republican’s answers on health care were even more striking.

Following up on Friday’s release of 2011 tax returns, Scott Pelley asked whether it’s fair that Romney pays a lower federal income tax rate than “the guy who makes $50,000.” The Republican conceded it’s a “low rate,” but nevertheless said it’s fair – the reduced rate is the “right way to encourage economic growth – to get people to invest, to start businesses, to put people to work.”

This is no small admission. The multi-millionaire candidate pays a lower tax rate than most of the middle class – and the rate would have been even lower had Romney not artificially inflated it purely for political reasons – and if elected, he’ll fight to keep it that way.

But this exchange on health care struck me as every bit as interesting.

Pelley: Does the government have a responsibility to provide health care to the 50 million Americans who don’t have it today?

Romney: Well, we do provide care for people who don’t have insurance, people – we – if someone has a heart attack, they don’t sit in their apartment and die. We pick them up in an ambulance, and take them to the hospital, and give them care. And different states have different ways of providing for that care.

Pelley: That’s the most expensive way to do it.

Romney: Well the–

Pelley: In an emergency room.

When it comes to health care policy, this might be one of the more important moments of the presidential race. Romney doesn’t believe the United States has a responsibility to provide health care coverage to its own citizens – the Republican Party is the only major political party in any democracy on the planet to hold this position – but he does see emergency rooms as an avenue for caring for the uninsured.

And as a policy matter, that’s deeply absurd.

Long time readers may recall this is a long-time focus of mine, but so long as it keeps coming up, it’s worth setting the record straight from time to time.

It’s true that under the preferred Republican system – American health care before the Affordable Care Act passed – if you’re uninsured and get sick, there are public hospitals that will treat you. As Romney noted on camera, if you have a heart attack, you can call 911 and medical professionals will come get you and give you care.

But it’s extremely expensive to treat patients this way, and it would be far cheaper, and more medically effective, to pay for preventative care so that people don’t have to wait for a medical emergency to seek treatment.

For that matter, when sick people with no insurance go to the E.R. for care, they often can’t pay their bills. Since hospitals can’t treat sick patients for free, the bills can still bankrupt those who get sick, and the costs are still passed on to everyone else.

In other words, it’s the most inefficient system of socialized medicine ever devised.

And in the bigger picture, it’s worse than that. For those with chronic ailments, this position is a pathetic joke – is anyone going to stop by the emergency room for chemotherapy or diabetes treatments?

Romney’s argument isn’t a responsible approach to American health care in the 21st century; Romney’s argument is ridiculous.